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PubMed1991

Influence of physical activity and dietary restraint on resting energy expenditure in young nonobese females.

An understanding of the physiological and behavioral determinants of resting energy requirements is important to nutritional considerations in females. We examined the influence of endurance training and self-reported dietary restraint on resting metabolic rate and fasting plasma hormones in 44 nonobese females characterized for body composition, maximal aerobic power (VO2 max), and daily energy intake. To examine the association of metabolic rate and dietary restraint with hormonal status, fasting plasma levels of insulin, glucose, and thyroid hormones (total and free fractions of thyroxine and triiodothyronine) were determined. In univariate analysis, resting metabolic rate (kcal.min-1) was positively related to VO2 max (L.min-1) (r = 0.54; p less than 0.01). This relationship, however, was partially dependent on body size, since fat-free mass was also related to resting metabolic rate (r = 0.42; p less than 0.01) and VO2 max (L.min-1) (r = 0.75; p less than 0.01). After controlling for fat-free weight using partial correlation analysis, the relation between RMR and VO2 max was weaker but controlling for fat-free weight using partial correlation analysis, the relation between RMR and VO2 max was weaker but still significant (partial r = 0.38; p less than 0.05). On the other hand, high levels of dietary restraint were associated with higher levels of body fat (r = 0.31; p less than 0.05) and a lower resting metabolic rate (r = -0.29; p = 0.07). These associations persisted after control for differences in fat-free mass. Total energy intake as well as total and free levels of triiodothyronine were not related to resting metabolic rate or level of dietary restraint.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1979

Cutaneous masking. I. Psychophysical observations on interactions of multipoint stimuli in man.

1. Psychophysical masking of cutaneous sensation at the locus of punctate test stimulation has been quantitatively examined with phasic mechanical and brief air-pulse stimuli using a conditioning-test stimulus paradigm. 2. Masking was maximal at the minimal interstimulus distance effective with this paradigm, varies inversely with interstimulus distance, and is demonstrable with the conditioning and test stimuli up to 10 cm apart on the forearm. 3. The degree of masking was found to be a direct function of the relative intensity of the conditioning stimulus with respect to the test stimulus. 4. Variations in the interstimulus interval permitted an investigation of the temporal features of cutaneous masking. It was detectable from 10 ms before to 70 ms after conditioning stimulation. Maximum masking occurred when the test stimulus was delivered about 10 ms following conditioning stimulus onset. 5. We also noted the much less marked, but still significant, enhancement phenomenon, in which weak conditioning stimuli, at just-threshold intensity levels, lowered the detection threshold for sensation at the test stimulus locus. We found this enhancement of sensation to have the same spatial distribution as did masking, but a much reduced time course. It began with the test stimulus presented simultaneously with the conditioning stimulus, peaked with 10--15 ms interstimulus intervals, but decayed in less than 40 ms. 6. Since psychophysical experiments often form the framework for the understanding of physiologic processes, it is suggested that these behavioral determinations of enhancement and masking may be correlated with the electrophysiologic properties of excitation and inhibition in neurons of the major primary somatic pathways of the central nervous system.

Animals↗
PubMed1977

Newborn dopamine-beta-hydroxylase, minor physical anomalies, and infant temperament.

The authors examined newborn anomaly scores for 193 normal infants in relation to obstetrical history, newborn dopamine-beta-hydroxylase (DBH), and 5-month (N=185) and 1-year (N=123) infant behavior, determined by a questionnaire completed by their mothers. There was no significant relationship between anomaly score and obstetrical history or 5-month infant temperament; low significant correlations were found between newborn DBH and 1) infant irritability and unsociable response and 2) 1-year anomaly scores and reported activity levels. The authors discuss the possible importance of these findings.

Child Behavior↗
PubMedDate not supplied

Development of hearing loss in kanamycin treated chinchillas.

Behaviorally determined auditory thresholds of chinchillas were monitored before, during and after daily administration of kanamycin sulfate (200 mg/kg per day). Drug treatment was terminated as soon as a shift in high-frequency thresholds was observed. In surviving animals, hearing loss spread toward lower frequencies and stabilized after eight to nine days. The stable hearing loss was limited, on the average, to frequencies above 3 kHz. The magnitude of the loss was constant across frequencies and averaged about 40 dB. Virtually complete outer hair cell loss was seen in the basal portion of the cochleae of all surviving animals.

Animals↗
PubMed1991

Activity feedback to the mammalian circadian pacemaker: influence on observed measures of rhythm period length.

In the mouse, activity is precisely timed by the circadian clock and is normally most intense in the early subjective night. Since vigorous activity (e.g., wheel running) is thought to induce phase shifts in rodents, the temporal placement of daily exercise/activity could be a determinant of observed circadian rhythm period. The relationship between spontaneous running-wheel activity and the circadian period of free-running rhythms was studied to assess this possibility. With ad libitum access to a running wheel, mice exhibited a free-running period (tau) of 23.43 +/- 0.08 hr (mean +/- SEM). When running wheels were locked, tau increased (23.88 +/- 0.04 hr, p less than 0.03), and restoration of ad libitum wheel running again produced a shorter period (tau = 23.56 +/- 0.06 hr, p less than 0.05). A survey of free-running activity patterns in a population of 100 mice revealed a significant correlation between the observed circadian period and the time of day in which spontaneous wheel running occurred (r = 0.7314, p less than 0.0001). Significantly shorter periods were observed when running was concentrated at the beginning of the subjective night (tau = 23.23 +/- 0.04), and longer periods were observed if mice ran late in the subjective night (tau = 23.89 +/- 0.04), F (1, 99) = 34.96, p less than 0.0001. It was previously believed that the period of the circadian clock was primarily responsive to externally imposed tonic or phasic events. Systematic influences of spontaneous exercise on tau demonstrate that physiological and/or behavioral determinants of circadian timekeeping exist as well.

Animals↗
PubMed1992

Human immunodeficiency virus and hepatitis B virus infections in a New York City alcoholic population.

Alcoholics have previously been reported to have an increased susceptibility to hepatitis B virus (HBV) infection. Since human immunodeficiency virus (HIV) is transmitted in a similar fashion, we studied 143 consecutive in- and outpatient alcoholics residing in New York City for HIV and HBV prevalence and associated risk factors. Of these alcoholics, 19 (13%) individuals were HIV positive, 57 (40%) were hepatitis B seropositive. Intravenous drug use and sexual contact with an IV drug user were the most important risk behaviors for HIV acquisition, with large numbers of partners and anal heterosexual intercourse being lesser factors. The only significant risk behavior determined for hepatitis B infection was IV drug use. These high-risk behaviors did not appear to be related to episodes of alcoholic intoxication. However, it is conceivable that alcoholism may, in other ways, affect susceptibility to HIV infection.

Adult↗
PubMed1992

Household-based malaria control in a highly endemic area of Africa (Tanzania): determinants of transmission and disease and indicators for monitoring--Kilombero Malaria Project.

The Kilombero Malaria Project (KMP) attempts to define operationally useful indicators of levels of transmission and disease and health system relevant monitoring indicators to evaluate the impact of disease control at the community or health facility level. The KMP is a longitudinal community based study (N = 1024) in rural Southern Tanzania, investigating risk factors for malarial morbidity and developing household based malaria control strategies. Biweekly morbidity and bimonthly serological, parasitological and drug consumption surveys are carried out in all study households. Mosquito densities are measured biweekly in 50 sentinel houses by timed light traps. Determinants of transmission and indicators of exposure were not strongly aggregated within households. Subjective morbidity (recalled fever), objective morbidity (elevated body temperature and high parasitaemia) and chloroquine consumption were strongly aggregated within a few households. Nested analysis of anti-NANP40 antibody suggests that only approximately 30% of the titer variance can be explained by household clustering and that the largest proportion of antibody titer variability must be explained by non-measured behavioral determinants relating to an individual's level of exposure within a household. Indicators for evaluation and monitoring and outcome measures are described within the context of health service management to describe control measure output in terms of community effectiveness.

Animals↗
PubMed2026

Digital Structured Education With Behavioral Nudge Tools for Adults With Type 2 Diabetes: Multicenter Randomized Controlled Trial.

BACKGROUND: Digital interventions offer scalable alternatives to traditional face-to-face diabetes education, but often face challenges related to inconsistent clinical effectiveness, and declining user engagement. However, whether a digital structured education program integrated with behavioral nudge tools can improve metabolic, behavioral, and psychological outcomes in adults with type 2 diabetes remains unclear. OBJECTIVE: This study aimed to evaluate the effectiveness of a digital structured education program integrated with behavioral nudge tools in improving metabolic, behavioral, and psychological outcomes among adults with type 2 diabetes. METHODS: This multicenter randomized controlled trial was conducted in the endocrinology departments of 4 hospitals in China. Adults with type 2 diabetes were randomly assigned to an intervention group receiving a digital structured education program integrated with behavioral nudge tools (n=146) or a control group receiving standard digital diabetes education (n=147). Assessments were conducted at baseline and 12-week follow-up. The primary outcome was hemoglobin A1c (HbA1c) at 12 weeks, adjusted for baseline HbA1c, and study center. Secondary outcomes included fasting blood glucose (FBG), weight, BMI, waist circumference, blood pressure, lipid profiles, self-management behaviors, self-efficacy, and habit strength. RESULTS: Among 293 participants (mean age 49.19, SD 10.02 y), 287 (97.9%) completed follow-up. At 12 weeks, the intervention group demonstrated significantly greater improvements than the control group in HbA1c (adjusted mean difference -0.38%, 95% CI -0.68% to -0.09%; P=.01), FBG (adjusted mean difference -0.75, 95% CI -1.27 to -0.44 mmol/L; P<.001), weight (adjusted mean difference -0.84, 95% CI -1.61 to -0.07 kg; P=.03), BMI (adjusted mean difference -0.38, 95% CI -0.65 to -0.11 kg/m&#xb2;; P=.01), systolic blood pressure (adjusted mean difference -2.71, 95% CI -4.62 to -0.79 mm Hg; P=.01), diastolic blood pressure (adjusted mean difference -2.92, 95% CI -4.47 to -1.37 mm Hg; P<.001), and total cholesterol (adjusted mean difference -0.27, 95% CI -0.48 to -0.05 mmol/L; P=.02). The intervention was also associated with significantly greater improvements in self-management behaviors, self-efficacy, and habit strength (all P<.05). CONCLUSIONS: Digital structured education integrated with behavioral nudge tools improved metabolic outcomes and strengthened psychological and behavioral determinants of self-management among adults with type 2 diabetes over a 12-week period. These findings suggest that a digital structured education program integrated with behavioral nudge tools may enhance diabetes self-management beyond standard digital diabetes education. Further studies with longer follow-up and real-world implementation are warranted to evaluate the sustainability, generalizability, and long-term clinical impact of this integrated intervention.

Humans↗
PubMed1992

Psychology and decision making: modelling health behavior with multiattribute utility theory.

The success of much of dental practice is linked to patient behavior. Understanding the issues that influence patients' decisions when they choose to not follow preventive or therapeutic dental recommendations is instrumental to improving adherence, and ultimately, to improving dental health outcomes. Multiattribute Utility Theory (MAU) provides a methodology for systematically exploring these issues. It is based on a well-established body of knowledge in the psychological literature, and currently represents a state-of-the-art model for predicting behavior and delineating potentially modifiable behavioral determinants. Two examples are presented to illustrate how MAU can be used in clinical settings. In the first example, MAU is used to identify key reasons why nearly 70 percent high-risk patients did not obtain flu shots, a behavioral problem comparable to many confronted in dentistry. MAU correctly predicted the vaccination behavior of 82 percent of patients, and an intervention based on MAU findings nearly doubled vaccination rates. The second example used MAU to identify physician behaviors that influenced patients' satisfaction with an ambulatory care visit. MAU findings from this study identified specific behaviors in a provider's style that if modified may improve patient satisfaction. These MAU applications also emphasize the importance of soliciting the patient's perspective in clinical interactions since some of the most important determinants of patient behavior are not represented in traditional clinical decision models.

Decision Making↗
PubMed1979

Health for and by the people.

The need to extend the search for health beyond the current efforts to control disease is emphasized by citing the deficienceis of the current health care model systems. The escalating costs of health care delivery, the emphasis of the current system on treating episodic illnesses rather than chronic disabilities, and the fact that the health care system has less of an impact on health status than socio-economic and life style factors represent major deficiencies in health care delivery. Further, the fragmentation and specialization in education and health care, the exclusion of behavioral science teaching, and the teaching of behavioral determinants of diseases are additional deficiencies of health professions education. The need to develop clear and explicit national health policies, including monitoring of health both of people and communities using indices that relate not only to diseases but also to the qualitative aspect of life, is viewed as an essential prerequisite for the health care system. The assignment of much greater priority to the training of a community health worker and health educator is stressed.

Behavioral Sciences↗
PubMed1978

The treatment of malignant melanoma of the skin.

This review of 117 melanomas occurring in 115 patients treated by a single surgeon suggests the appropriateness of the therapeutic decisions to be mentioned based upon tumor behavior, determined by microstaging. Local control of level II lentigo maligna melanoma was achieved, in most instances, by local excision with visibly free margins and primary closure. In most of the other instances of melanoma, adequate local control was accomplished by wide three-dimensional excision, 5 centimeter margins--closure usually required grafting. Minor amputation was performed with satisfactory results in those patients with appropriate lesions in the volar-subungual area. Regional lymphadenectomy in patients with level IV and V disease in whom the tumors drained to a single node basin revealed occult metastases in 25 per cent of the patients and, therefore, appears warranted as prophylactic treatment. Preliminary data on recurrences suggest that the frequency of the recurrence paralleled the biologic aggressiveness of the tumor, determined by microstaging in association with the presence or the absence of lymph node metastases.

Adolescent↗
PubMed1990

Contraceptive behavior among sexually active Hispanic adolescents.

The purpose of this study was to examine those factors associated with the contraceptive behavior of a national representative sample of Hispanic female adolescents. The subjects included all (n = 85) unmarried, sexually active Hispanic women, aged 15 to 19, from the 1982 National Survey of Family Growth. Contraceptive behavior was measured on a normalized scale, ranging from oral contraceptives to no contraception. Mexican/American and Central/South American background females were more likely (p less than 0.031) to use effective birth control than Puerto Rican, Cuban, and other Hispanic background subjects. Twenty additional social, behavioral, and demographic variables were found to be significantly associated (p less than 0.05) with contraceptive behavior. Based on multiple regression analysis, seven of these variables were found to explain 62% (p less than 0.0001) of the variation in the contraceptive behavior of this sample. Poorer contraceptive behavior was associated with noncompliance with the initial birth control method used (33.8%), lower coital frequency (8.3%), older postmenarchial age (5.7%), failure to use birth control at first coitus (4.6%), fewer years dating (4.0%), lower frequency of church attendance (3.3%), and never having experienced a pregnancy scare (2.0%). These findings suggest that the contraceptive behavior of Hispanic female adolescents is a dynamic process that can be understood in the context of previous sexual and contraceptive behavior.

Adolescent↗
PubMed1992

Sexual intercourse, contraception, and risk-taking behavior among unselected French adolescents aged 11-20 years.

An epidemiological study was carried out among 4,255 adolescents, aged 11-19 years, randomly selected from secondary schools in a northern urban area of France. The questionnaire concerned sexual activity, contraception, health status, licit and illicit drug consumption, and other risk-taking behavior. A total of 31% of the adolescents had had sexual relations (43% of the boys, 20% of the girls). Sexual activity increased with age. A large majority (70%) of the sexually active adolescents used some form of contraception. The study confirms the relationship between smoking, drinking, illicit drug consumption, and sexual activity, but shows that contraceptive behavior is not related to problem behavior.

Adolescent↗
PubMed1992

Context and content: the impact of school-leaving and school-based health education on AIDS-relevant cognitions.

A survey examined health beliefs and intentions among 690 16-18 year-olds in Dundee. Respondents in the younger cohort (n = 363) were classified according to their educational situation (at school vs left) and self-reports of having received AIDS/HIV-relevant health education. Both remaining in school and receiving AIDS/HIV-relevant health education had independent beneficial effects, but the effects of leaving school also interacted with sex of respondent and with amount of relevant education received prior to leaving. Males' and females' reliance on mass media and other information sources diverged once they left school, indicating that males who leave school early are most likely to disregard useful or important information regarding AIDS. Consistent with this finding, leaving school reduced the difference between males' and females' intention to use condoms with a new partner. The beneficial impact of having previously received AIDS/HIV-relevant education on beliefs concerning the controllability of the epidemic and on feeling worried about everyday contact with a person with HIV/AIDS, was most marked among those who had left school. The results are discussed in terms of their implications for health education strategies.

Adolescent↗
PubMedDate not supplied

Female education, age, parity, and reproduction cessation in Ghana.

Data from the 1988 Ghana Demographic and Health Survey is employed to determine the existence of a relationship between the amount of education a woman has and her intent to cease childbearing. The findings are that with increasing levels of education, a female's desire to cease reproduction also increases. However, this relationship is obscured if parity is not controlled.

Adult↗
PubMed1992

Predictors of repeat pregnancy outcome among black and Puerto Rican adolescent mothers.

This prospective study investigated predictors of repeat pregnancies by 12 months after the delivery of a first child and their outcomes in inner-city adolescent mothers. The sample included four groups: those who had therapeutic abortions, miscarriages, full-term deliveries, and no repeat pregnancy. The therapeutic abortion group had more pregnancies before their first delivery (41%) than did full term (20%) and no repeat (15%), p less than .01. More delayed grade placement was found in therapeutic abortion -1.6 years (1.3) and full term -1.8 years (.9) than in no repeat pregnancy -.6 years (1.1), p less .001. Reading achievement scores were higher in no repeat 86.3 (17.1) than in full term 75.0 (16.5), p less than .05. School attendance was higher in no repeat (65%) than in therapeutic abortion (35%) and full-term (24%) p less than .01 groups. Depressive symptoms at baseline were higher among therapeutic aborters 18.9 (9.9) than among full term 10.2 (8.2) and no repeat pregnancy groups 12.2 (6.2). Logistic regression analyses identified delayed grade placement as the most important predictor of pregnancy outcome.

Achievement↗
PubMed1992

Determinants of sexual habits in Italian females.

OBJECTIVE: To identify characteristics of women reporting multiple sexual partners and early age at first intercourse in Italy. METHOD: Information on 1139 control women (median age 54 years) interviewed as part of a case-control study of cervical neoplasia conducted in the greater Milan area, Northern Italy were analysed using stratified analysis and multiple logistic regression. RESULTS: Overall, 81% of the study sample reported no more than one sexual partner, 10% two and 9% three or more. The proportion reporting multiple sexual partners tended to be higher among younger and more educated women (4% vs 19% of women with respectively less than 7 and 12 or more years of education reported three or more partners). Ever smokers reported a higher number of sexual partners than never smokers. The proportion of nulliparae reporting three or more sexual partners was higher than that of parous women. These findings were confirmed after taking into account in a multivariate analysis the role of potential confounding factors. Furthermore similar findings emerged from an analysis restricted to women aged 40 years or less. Always considering number of sexual partners, no relationship emerged with marital status, spontaneous or induced abortions, lifetime number of reported Pap smears and contraceptive habits. With reference to age at first intercourse, 25% of the study population reported their first intercourse at age 18 or before, 34% between 19 and 22 years, and 41% at age 23 or later. Younger women (that is, more recent cohorts) more frequently reported earlier age at first intercourse and the proportion of never married women reporting early intercourse was higher (51% vs 22% of never married vs married women). No relationship emerged between education, smoking habits, parity, history of spontaneous or induced abortions, number of Pap smears, contraceptive habits, and age at first intercourse. CONCLUSION: This study documents conservative sexual habits in Northern Italian females (at least on the basis of self reporting) but indicates that any educational compaigns towards safe sex should be focused towards younger women, particularly smokers, unmarried and nulliparae.

Abortion, Induced↗
PubMed1992

A study of the cognitive aspects of sexual decision making in adolescent females.

A comprehensive sexuality questionnaire was administered to 37 females, ages 13 through 16 years, who attended clinics for routine health care. Subjects completed standardized scales of self-concept, locus of control, and future orientation. They also were given a short battery of standardized cognitive tests. Three groups were identified: Group 1 was sexually active and using contraception reliably, Group 2 was not using contraception reliably, and Group 3 had not been sexually active. Group 1 adolescents had higher scores on the vocabulary subtest of the WISC-R (F = 3.4, p less than .05) than did Group 2 adolescents, over and above the effect of socioeconomic status (SES). Group 1 subjects had higher scores on knowledge of sex and contraception than did Group 2 (F = 3.3, p less than .05). Group 1 had more internal locus of control (F = 7.0, p less than .005) than did Group 2 over and above the effect of SES. Mean scores for Group 3 adolescents were intermediate and not significantly different. The findings suggest that cognitive factors may influence contraceptive behavior in adolescent females.

Adolescent↗